Crowns, Bridges, Dentures, Implants

Bone problems and dental work..

01/05/2008

Question:

I have severe bone problems and would like to take one of the medications that might help...Actonel, Fosamax. I do have serious dental work that needs to be done. Will taking either one of these drugs create a problem when I have dental work done?

Answer:

You present lots of variables here that would need clarification such as the nature of your bone disease and the dosing of the medications you mentioned. But either of them CAN create problems if you need significant dental work, especially work that involves surgical procedures with the jawbones.

The best information we currently have would suggest that any needed surgeries (including tooth extraction) should be completed as soon as possible. Most ideally, all surgeries should be completed before you start the Actonel or Fosamax. But if your physician thinks you need to start these drugs immediately, extractions or other surgeries can still be performed safely. Since jaw problems (occasionally called osteonecrosis of the jaws or ONJ) appear to be directly related to the total time and total dose that you use these medicines, the sooner any needed surgery is performed after you begin taking these drugs, the lower the risk of ONJ.

Most experts agree that the risk for ONJ is extremely low with the oral medicines, especially for patients who have taken them for less than 2-3 years. Since every case is unique, I would recommend that you seek a consultation with an oral and maxillofacial surgeon to discuss your dental needs in person.

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